NEW lab results- please help interpret!
Posted 04 May 2012 - 11:01 AM
The results read:
Rickettsial Fever Abs
RMSF, IgG, EIA POSITIVE
RMSF, IgG, IFA <1:64 <1:64 negative 1:64 positive recent/active >1:64
Q Fever Phase I negative
Q Fever Phase II negative
Lyme PCR, Bb negative
Note says this negative PCR does NOT rule out possibility of infection or Lyme borreliosis.
His bartonella and babesia duncani (WA1), and erlichia were negative. His MTHFR negative.
His WBC are low at 3.5. They were also low when we did initial labs on Feb. 28, then were back in normal range with labs done March 16, now labs done April 25 back down to 3.5. His other out of range labs are HIGH Eos 6.0 normal(0-4), and LOW neutrophils(absolute)1.1 normal(1.2-5.2)
His western blot (again done at lab corp) is different then it was in February. It was positive for IgG bands 23,30, 41 in Feb. Now it is only positive for IgG band 41.
Serum creatinine HIGH at 0.60 normal(0.3-0.59)
Both IgG and IgM mycoplasma pneumo negative
Rocky mountain spotted fever IgM 0.07 negative negative <0.90
Thank you so much for any help!
Posted 04 May 2012 - 01:37 PM
edit- daughter's RMSF IgM was negative.
Edited by philamom, 05 May 2012 - 11:58 AM.
Posted 04 May 2012 - 05:33 PM
Posted 05 May 2012 - 08:35 AM
Posted 05 May 2012 - 09:55 AM
Posted 05 May 2012 - 12:28 PM
Here's an article on it. 83% of ticks in the study were found to be infected at the beginning of 'tick season' in May which is when my son was bit.
My son's doctor did treat him with doxy briefly just to be sure the infection was addressed, even though it was two years after the tick bites. He was only 6 at the time, so we couldn't do doxy for very long... only about a week.
Edited by JT's Mom, 05 May 2012 - 12:34 PM.
Posted 07 May 2012 - 04:24 AM
That makes complete sense b/c he had multiple, different extreme rashes, but not the typical one you get with RMSF (on palms and soles of feet). This is what it probably was or is, the rickettsia parkeri. Thank goodness my LLMD put him on doxycycline despite of his age. I only kept him on the doxycycline for 3 weeks b/c I was nervous about the possibility of teeth staining although my LLMD said at a recent conference, the Institute of Medicine said teeth staining with doxy was an "urban myth", that it only occurs with tetracycline. I have searched high and low for confirmation of this and here it is, straight from the CDC themselves. It is the treatment for rickettsia in any age person, endorsed by the AAP. The bolded and underlined is mine.
Doxycycline is the drug of choice for treatment of all TBRD in children and adults. This drug is bacteriostatic in its activity against rickettsial organisms. The recommended dose is 100 mg per dose administered twice daily (orally or intravenously) for adults or 2.2 mg/kg body weight per dose administered twice daily (orally or intravenously) for children weighing <100 lbs. (45.4 kg). Intravenous therapy is frequently indicated for hospitalized patients, and oral therapy is acceptable for patients considered to be early in the disease and who can be managed as outpatients. Oral therapy also can be used for inpatients who are not vomiting or obtunded. The optimal duration of therapy has not been established, but current recommendations for RMSF and HME are for treatment for at least 3 days after the fever subsides and until evidence of clinical improvement is noted, which is typically for a minimum total course of 5--7 days. Severe or complicated disease might require longer treatment courses. Patients with HGA should be treated with doxycycline for 10--14 days to provide appropriate length of therapy for possible incubating coinfection with Lyme disease (45).
The use of tetracyclines to treat children with TBRD is no longer a subject of controversy (56--58). Concerns regarding dental staining after tetracycline therapy have been based primarily on studies conducted during the 1960s that involved children receiving multiple courses of the drug for recurrent otitis media (59,60). The propensity of tetracyclines to bind calcium can lead to darkening of the teeth if the antibiotic is ingested during the period of tooth crown formation. More recent studies in 1971 and 1998, however, have demonstrated that although multiple exposures to tetracycline increase the risk for tooth staining, limited use of this drug in children during the first 6--7 years of life has a negligible effect on the color of permanent incisors (56,57). Beyond ages 6--7 years, the risk for tetracycline staining is of minimal consequence because visible tooth formation is complete. Moreover, a prospective study of children treated with doxycycline for RMSF demonstrated that these children did not have substantial discoloration of permanent teeth compared with those who had never received the drug (56). Because TBRD can be life-threatening and limited courses of therapy with tetracycline-class antibiotics do not pose a substantial risk for tooth staining, the American Academy of Pediatrics Committee on Infectious Diseases revised its recommendations in 1997 and has identified doxycycline as the drug of choice for treating presumed or confirmed RMSF and ehrlichial infections in children of any age (61,62).
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